John Zeisel ’65 Takes New Approach to Alzheimer’s Care

John Zeisel ’65, ’71 GSAS (left) talks with one of his Alzheimer’s patients. Photo: Courtesy Hearthstone Alzheimer CareIt can be done with a favorite work of art, a familiar piece of furniture or even a comforting touch to the cheek.

A soothing environment can ease the anxiety and confusion felt by those within the grip of Alzheimer’s disease, and that friendly stimulation can alleviate some of the stress felt not just by patients but also by their concerned loved ones.

That revolutionary approach, which emphasizes a non-medicinal method to dealing with one of the nation’s fastest-growing health care crises, is central to the work of John Zeisel ’65, ’71 GSAS, a sociologist who firmly believes that a diagnosis of Alzheimer’s does not mark the end of a life, but rather the start of a new chapter within one.

“We are countering the idea that a diagnosis equals a ‘sentence’,” says Zeisel. “We need to get rid of that stigma and treat them as people, not patients.

“Many people with Alzheim­er’s live 10–15 years after an initial diagnosis and with a new approach, the quality of their lives can still remain high.”

Zeisel’s focus, detailed in his recent book, I’m Still Here: A Breakthrough Approach to Understanding Someone Living with Alzheimer’s, is to create warm, inviting surroundings for those with the disease. Gone are the sterile white walls, the harsh lighting and the impersonal treatment usually associated with nursing homes devoted to caring for Alzheimer’s patients.

In their place, Zeisel recommends decorating walls with family photos (often labeled with the loved ones’ names, to act as a prompt), building common spaces that lead to interactions with other patients and providing stimulations — such as a trip to a theater or ballgame — that can even create new memories.

“A patient doesn’t lose his or her sense of self, but Alzheim­er’s just makes it harder to find,” says Zeisel. “That person is still yelling out, through the fog of the disease, that ‘I’m still here,’ and we help his or her loved ones see that.”

Perhaps foreshadowing his academic future, Zeisel grew up in Morningside Heights in a building on West 115th Street and Riverside Drive now owned by Columbia. Though he made a point of exploring the city as much as he could while an undergraduate, he also cherished the Core Curriculum, majored in Oriental studies and minored in literature.

But his calling was elsewhere.

“Sociology just fit for me,” he says. “It changed the way I thought. The research taught me, more than anything, how to look at the world and then try to improve upon it.

“That mantra shaped everything in my life afterward.”

After receiving his Ph.D. in sociology in 1971 and then a Loeb Fellowship at Harvard’s Graduate School of Design, Zeisel taught at Yale and McGill before returning to Cambridge and Harvard’s Architecture School. There, he focused on constructing “better buildings,” structures that were not just functional or aesthetically pleasing, but actually improved the lifestyle and health of those working or living inside them.

Believing that the interiors of offices affected employees psychologically, Zeisel emphasized workplace lighting and layout that people intuitively responded to when he designed the 350-person newsroom at the Minneapolis Star-Tribune.

“The goal was to design hospitals that help people heal faster or offices that would reduce stress and increase productivity,” says Zeisel, who published his theories in the 1984 book Inquiry by Design: Environment/Behavior/Neuro­science in Architecture, Interiors, Landscape, and Planning. That concept — that the interior spaces of buildings could reduce stress — led Zeisel to what he considers his life’s work: helping patients with Alzheimer’s disease. More than 5.3 million Americans suffer from the often-misunderstood condition, creating more than $100 billion in health care costs annually.

No cure yet exists, but Zeisel strongly disputes the current pervasive thinking — often reinforced by movies or television — that relatives have no choice but to stand idly by as their loved ones slip away into a morass of confusion and even anger.

Using the principles he eventually outlined in I’m Still Here, Zeisel co-founded Hearthstone Alzheimer Care, which runs seven facilities in New York and Massachusetts.

Hearthstone, which also is affiliated with facilities elsewhere in America as well as Australia and Brazil, tries to help patients overcome the difficulties they have with their physical environment. Through smart and safe design, these homes battle the four “A’s” of Alzheimer’s suffered by the patients and their loved ones: anxiety, agitation, aggression and apathy, Zeisel believes.

“We engage them in the world and we encourage them to engage with each other,” says Zeisel, who notes that the Hearthstone facility on the Upper West Side exposes its residents to new stimulation thanks to partnerships with New York institutions such as the Big Apple Circus and Tribeca Film Institute.

“Certain parts of the brain can be engaged and lead to rewarding moments for the patients and their families,” says Zeisel, who splits his time between New York, Massachusetts and Montreal, where his wife teaches. The couple has four children, including Evan ’02.

“This is a glass-half-full approach,” said Zeisel. “We don’t give up on anyone.”

Jonathan Lemire ’01, a frequent contributor to CCT, is a staff writer for The New York Daily News.